On The Defense of Male Genital Mutilation

In Wednesday's P-G, I read a stunning, faith-based defense of male genital mutilation.

And let me say right now that I reserve the right to use that phrase instead of its gentler euphemistic cousin "circumcision" because, simply put, when one surgically removes the foreskin from the the penis a mutilation of the genitals has occurred. It is all more horrific when one understands that it's done involuntarily to babies as young as a few days old.

Back to the defense. Professor Steven L Jones of Grove City College begins:

The citizens of San Francisco will decide in November whether to ban circumcision, a practice that dates from antiquity and is embraced by at least three of the world's major religions.

Gotta stop him there. It's not exactly a ban. It's not a ban in the same sense that all heroin use is banned or all cigarette smoking in public places is banned. The law only applies to the genital mutilation of male minors. And there is an exception for the health of the minor as well.

Let's take a look at the proposed measure:

Section 1: The San Francisco Police Code is hereby amended by adding Article 50 to read as follows:

ARTICLE 50: GENITAL CUTTING OF MALE MINORS

SEC. 5001. PROHIBITION OF GENITAL CUTTING OF MALE MINORS.
Except as provided in SEC. 5002, it is unlawful to circumcise, excise, cut, or mutilate the whole or any part of the foreskin, testicles, or penis of another person who has not attained the age of 18 years.

SEC. 5002. EXCEPTIONS.
(a) A surgical operation is not a violation of this section if the operation is necessary to the physical health of the person on whom it is performed because of a clear, compelling, and immediate medical need with no less-destructive alternative treatment available, and is performed by a person licensed in the place of its performance as a medical practitioner.

(b) In applying subsection (a), no account shall be taken of the effect on the person on whom the operation is to be performed of any belief on the part of that or any other person that the operation is required as a matter of custom or ritual.

SEC. 5003. PENALTY.
Any person who violates any provisions of this Article shall be deemed guilty of a misdemeanor and upon conviction such person shall be punished by a fine not to exceed $1,000 or by imprisonment in the County Jail for a period not to exceed one year, or by both such fine and imprisonment.

It's a fine distinction I realize, but according my reading of Section 5001, if a lad of 18 years decides for himself to mutilate his genitals this measure can not stop him. He's perfectly free to do so.

Back to Professor Jones' next paragraphs:

Now, the fact that something stretches far back into human history is by no means a guarantee that it has social value. Slavery, human sacrifice and arranged marriages for adolescents also have long histories, but, thankfully, are no longer accepted by Western societies. The question is whether circumcision belongs on this list.

It doesn't.

It does. But I'll let Professor Jones continue:

The Centers for Disease Control reports that circumcision has numerous health benefits. Circumcised infants have fewer urinary tract infections, a blessing to any young family already stretched by numerous doctor visits.

I am sure the prospect of protecting a baby boy from a Urinary Tract Infection is a good thing, but let's look closer at UTIs in infants. How often does it occur?

From the American Academy of Pediatrics Policy Statements on Circumcision and Urinary Tract Infection:

It is estimated that 10 of 1000 (1%) uncircumcised male infants will develop a UTI during the first year of life compared with 1 of 1000 (0.1%) circumcised male infants.

So while it's true that a genitally mutilated boy will have fewer urinary tract infections, most boys (mutilated or not) will not have one in the first place.

Back to Professor Jones:

International studies from Africa, Asia and the United States also have found that circumcision lowers the likelihood of HIV infection and a host of other sexually transmitted diseases. And the CDC report makes clear that this is not just attributable to behavioral or lifestyle issues that may be correlated with circumcision. The procedure itself results in lower rates of STD infection and may lower the risk for certain types of cancer, too.

While Professor Jones paints a rosy picture of the benefits of male genital mutilation, the American Academy of Pediatrics is far less supportive. From the Abstract of the AAP's Policy Statement itself:

Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision. [Emphasis added.]

But what about the hygiene benefits?

Circumcision has been suggested as an effective method of maintaining penile hygiene since the time of the Egyptian dynasties, but there is little evidence to affirm the association between circumcision status and optimal penile hygiene. [Emphasis added.]

Penile cancer?

An annual penile cancer rate of 0.9 to 1.0 per 100 000 translates to 9 to 10 cases of penile cancer per year per 1 million men. Although the risk of developing penile cancer in an uncircumcised man compared with a circumcised man is increased more than threefold, it is difficult to estimate accurately the magnitude of this risk based on existing studies. Nevertheless, in a developed country such as the United States, penile cancer is a rare disease and the risk of penile cancer developing in an uncircumcised man, although increased compared with a circumcised man, is low. [Emphasis added.]

AIDS? Here's where it directly contradicts Jones:

Evidence regarding the relationship of circumcision to STD in general is complex and conflicting. Studies suggest that circumcised males may be less at risk for syphilis than are uncircumcised males. In addition, there is a substantial body of evidence that links noncircumcision in men with risk for HIV infection. Genital ulcers related to STD may increase susceptibility to HIV in both circumcised and uncircumcised men, but uncircumcised status is independently associated with the risk for HIV infection in several studies. There does appear to be a plausible biologic explanation for this association in that the mucous surface of the uncircumcised penis allows for viral attachment to lymphoid cells at or near the surface of the mucous membrane, as well as an increased likelihood of minor abrasions resulting in increased HIV access to target tissues. However, behavioral factors appear to be far more important risk factors in the acquisition of HIV infection than circumcision status. [Emphasis added.]

So if there's little, if any, medical benefit from male genital mutilation, then what's the issue here?

To Professor Jones, it's an issue of religious freedom and banning the mutilation will lead to worse things:

In the minds of the faithful, circumcision is not just an act performed on a given day; it is an initiation into a community and a way of life. And it is not the only such practice. Faith-based schooling, for example, is designed to instill and nurture faithful observance by religious adherents and is often chosen not by the child but by the parents.

Ban the mutilation today and Faith-based schooling is next.

If there's no real medical need for the mutilation and the only support for it is to "instill and nurture faithful observance" in a larger community, does that give parents have the right to mutilate their children?

But let's run a little mental experiment. If Jones is correct and there are health and well-being benefits to be had all for the cost of a foreskin, how many uncircumcised 18 year old men do you think would volunteer to have their genitals mutilated for those benefits?

Yea, I thought so.